Knowledge of binge eating disorder: a cross-sectional survey of physicians in the United States

ABSTRACT

Objectives: Binge eating disorder (BED)—now a designated disorder in the DSM-5—is the most prevalent eating disorder (ED), affecting 2–3% of the US population. This survey of US physicians assesses how BED is diagnosed, treated and referred.

Methods: Internists, family practitioners, obstetrics/gynecologist (OB/GYNs) and psychiatrists were randomly selected from a nationally-representative panel. Participants completed an online survey and reviewed case vignettes consistent with DSM-5-defined BED, then answered questions to elicit whether they would assess for psychiatric conditions including EDs. Those reporting they would screen and who correctly identified BED in vignettes received additional questions about BED diagnosis, treatment, and referral patterns.

Results: Of 278 physicians surveyed, 96% were board-certified and 87% had practiced >10 years. 23% were psychiatrists, 27% family practitioners, 31% internists and 19% OB/GYNs. 92% were ‘somewhat likely’ to screen for ED after reviewing DSM-5-consistent vignettes. 206 (74%) correctly identified BED. Of these, 33% and 68% reported they proactively screen eating habits for all patients and obese patients, respectively. 10% reported not screening eating habits even in the presence of ED symptoms. Fewer than half reported using DSM criteria in Diagnosing BED, and 56 (27%) did not recognize BED to be a discreet ED.

Conclusion: Although ED awareness is improving, understanding BED as a distinct ED is lacking, which may result in low rates of screening and diagnosis. This study illustrates how taking a complete patient history (including probing BED characteristics) may be an effective first-line strategy for clinicians to facilitate optimal care for these patients.

KEYWORDS:

• Binge eating disorder
• eating disorders
• general practice
• primary care
• psychiatry

Financial and competing interests disclosure

This research was conducted with funding and input from Shire Development, LLC. D Supina was an employee of Shire Development, LLC at the time the research was conducted. AC Shillington was an employee and shareholder of EPI-Q Inc, which received funding from Shire Development, LLC related to the design, execution, and report of this study. B Herman is an employee and shareholder of Shire Development, LLC. CB Frye was an employee of EPI-Q Inc. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. This study was presented as a poster (NR8-55) on 6 May 2014 at the 167th Annual Meeting of the American Psychiatric Association (APA).